Who gets to decide what it means to live a healthy lifestyle, and how important a healthy lifestyle is to a good life? As more governments make preventing obesity and diet-related illness a priority, it's become more important to consider the ethics and acceptability of their efforts. When it comes to laws and policies that promote healthy eating--such as special taxes on sugary drinks and the banning of food deemed unhealthy--critics argue that these policies are paternalistic, and that they limit (...) individual autonomy over food choices. In Healthy Eating Policy and Political Philosophy: A Public Reason Approach, Anne Barnhill and Matteo Bonotti show that both paternalistic justifications for healthy eating efforts and anti-paternalistic arguments against them can be grounded in perfectionist views that overly prioritize some values over others. The authors therefore propose a more inclusive, public reason approach to healthy eating policy that will be appealing to those who take pluralism and cultural diversity seriously, by providing a framework through which different kinds of values, including but not limited to autonomy and health, can be factored into the public justification for healthy eating efforts. Additionally, the book adopts a 'farm to fork' approach to the ethics of healthy eating efforts: it engages with theories and debates in political philosophy, considers the implications of different theoretical positions for healthy eating efforts, and then develops a concrete tool for assessing policies that will be of interest to both scholars and policymakers. As well as offering a novel normative analysis of healthy eating policy, the authors offer a new theoretical framework that will be applicable to a wide range of public policy scenarios. (shrink)

As concerns about the negative health effects of unhealthy eating, overweight and obesity have increased, so too have policy efforts to promote healthy eating. Federal, state, and local governments have proposed and implemented a variety of healthy eating policies. Many of these policies are controversial, facing objections that range from the practical (e.g., the policy won’t succeed at improving people’s diets) to the ethical (e.g., the policy is paternalistic or inequitable). Especially controversial have been policies limiting the options offered in (...) the marketplace, limiting access to certain options, or providing disincentives for the purchase of certain options. Examples of such policies include proposed .. (shrink)

The handbook is a partial survey of multiple areas of food ethics: conventional agriculture and alternatives to it; animals; consumption ethics; food justice; food workers; food politics and policy; gender, body image, and healthy eating; and, food, culture and identity. -/- Food ethics, as an academic pursuit, is vast, incorporating work from philosophy as well as anthropology, economics, environmental sciences and other natural sciences, geography, law, and sociology. This Handbook provides a sample of recent philosophical work in food ethics. This (...) philosophical work addresses ethical issues with agricultural production, the structure of the global food system, the ethics of personal food consumption, the ethics of food policy, and cultural understandings of food and eating, among other issues. The work in this Handbook draws on multiple literatures within philosophy, including practical ethics, normative ethics, and political philosophy, as well as drawing on non-philosophical work. Part I considers ethical issues concerning the industrial model of farming that dominates in developed countries, looking most closely at industrial crop farming and its environmental effects. Part II concerns the ethics of animal agriculture. Part III concerns the ethics of consumption: is it morally permissible to consume various products? Part IV concerns justice—including racial, social, and economic justice—in the food system. Part V discusses some ethical and legal issues with specific kinds of food policies, including healthy eating policies, food labeling, and agricultural guest worker programs. Part VI includes four essays taking a critical eye to our public discourse about, and personal experiences of, dieting, healthy eating, and obesity prevention. Lastly, the essays in Part VII concern the personal, social, and moral significance of food. (shrink)

This piece surveys recent work on the ethics of food production and distribution, paying closest attention to animal agriculture, plant agriculture, food justice, and food sovereignty.

This article surveys recent work on some issues in the ethics of food consumption. It is a companion to our piece on food justice and the ethics of food production.

Humans, animals, and the environment face a universal crisis: antimicrobial resistance. Addressing AR and its multi-disciplinary causes across many sectors including in human and veterinary medicine remains underdeveloped. One barrier to AR efforts is an inconsistent process to incorporate the plenitude of stakeholders about what AR is and how to stifle its development and spread—especially stakeholders from the animal agriculture sector, one of the largest purchasers of antimicrobial drugs. In 2019, The Wellcome Trust released Reframing Resistance: How to communicate about (...) antimicrobial resistance effectively, which proposed the need to establish a consistent and harmonized messaging effort that describes the AR crisis and its global implications for health and wellbeing across all stakeholders. Yet, Reframing Resistance does not specifically engage the animal agriculture community. This study investigates the gap between two principles recommended by Reframing Resistance and animal agriculture stakeholders. For this analysis, the research group conducted 31 semi-structured interviews with a diverse group of United States animal agriculture stakeholders. Participants reported attitudes, beliefs, and practices about a variety of issues, including how they defined AR and what entities the AR crisis impacts most. Exploration of Reframing Resistance’s Principle 2, “explain the fundamentals succinctly” and Principle 3, “emphasis that this is universal issue; it can affect anyone, including you” reveals disagreement in both the fundamentals of AR and consensus of “who” the AR crisis impacts. Principle 2 may do better to acknowledge that animal agriculture stakeholders espouse a complex array of perspectives that cannot be summed up in a single perspective or principle. As a primary tool to combat AR, behavior change must be accomplished first through outreach to stakeholder groups and understanding their perspectives. (shrink)

The American Medical Association prohibits physicians from giving placebos to their patients unless the patients are informed of and agree to the use of placebos.1 This prohibition, and the ethics of placebo treatment more generally, have been discussed in numerous recent papers (Finniss, Kaptchuk, Miller, et al. 2010; Shaw 2009; Foddy 2009; Miller and Colloca 2009; Kolber 2007; Blease 2010). Though some bioethicists support the AMA prohibition, others challenge it, arguing that using placebos without patients’ knowledge and consent—that is, using (...) placebos deceptively—can be ethical (Kolber 2007; Foddy 2009). This paper is about a specific ethical objection to use of placebos by physicians: deceptive .. (shrink)

In a recent article in this Journal, Shlomo Cohen and Haim Shapiro introduce the concept of “comparable placebo treatments” —placebo treatments with biological effects similar to the drugs they replace—and argue that doctors are not being deceptive when they prescribe or administer CPTs without revealing that they are placebos. We critique two of Cohen and Shapiro’s primary arguments. First, Cohen and Shapiro argue that offering undisclosed placebos is not lying to the patient, but rather is making a self-fulfilling prophecy—telling a (...) “lie” that, ideally, will become true. We argue that offering undisclosed placebos is not a “lie” but is a straightforward case of deceptively misleading the patient. Second, Cohen and Shapiro argue that offering undisclosed CPTs is not equivocation. We argue that it typically is equivocation or deception of another sort. If justifiable, undisclosed placebo use will have to be justified as a practice that is deceptive in most instances. (shrink)

Like the subtitle says, this is an intro to food ethics that also collects writings on food ethics by others. Topics include: animals, consumption, farming, identity, justice, paternalism, religion, and workers.

Many anti-obesity policies face a variety of ethical objections. We consider one kind of anti-obesity policy — modifications to food assistance programs meant to improve participants' diet — and one kind of criticism of these policies, that they are inequitable. We take as our example the recent, unsuccessful effort by New York State to exclude sweetened beverages from the items eligible for purchase in New York City with Supplemental Nutrition Support Program assistance. We distinguish two equity-based ethical objections that were (...) made to the sweetened beverage exclusion, and analyze these objections in terms of the theoretical notions of distributive equality and social equality. First, the sweetened beverage exclusion is unfair or violates distributive equality because it restricts the consumer choice of SNAP participants relative to non-participants. Second, it is disrespectful or violates social equality to prohibit SNAP participants from purchasing sweetened beverages with food stamps. We conclude that neither equity-based ethical objection is decisive, and that the proposed exclusion of sugar-sweetened beverages is not a violation of either distributive or social equality. (shrink)

In the midst of the recent Ebola outbreak, scientific developments involving infection challenge experiments on nonhuman primates sparked hope that successful treatments and vaccines may soon become available. Yet these studies pose a stark ethical quandary. On the one hand, they represent an important step in developing novel therapies and vaccines for Ebola and the Marburg virus, with the potential to save thousands of human lives and to protect whole communities from devastation; on the other hand, they intentionally expose sophisticated (...) animals to severe suffering and a high risk of death. Other studies that infect NHPs with a lethal disease in order to test interventions that may prove beneficial for humans pose the same ethical difficulty. Some advocates have argued that all research on primates should be phased out, and ethicists have questioned whether a moral justification of primate research is possible. A 2010 European Union directive banned virtually all research on great apes, and 2013 guidelines from the National Institutes of Health, based upon recommendations in an influential 2011 Institute of Medicine report, eliminated most biomedical research with chimpanzees in the United States. But studies involving other NHPs face no comparable restrictions. Should research on NHPs other than great apes be subject to tighter restrictions than it currently is? In this article, we explore this general question in the context of one particular type of biomedical research: infection challenge studies. We advocate a presumptive prohibition on infection challenge experiments in NHPs, but we also argue that exceptions to this prohibition are permissible, subject to strict substantive and procedural safeguards, when necessary to avert substantial loss of human life or severe morbidity for a substantial number of people. (shrink)

The pandemic of SARS-CoV-2 has led to unprecedented changes to society, causing unique problems that call for extraordinary solutions. We consider one such extraordinary proposal: ‘safer infection sites’ that would offer individuals the opportunity to be intentionally infected with SARS-CoV-2, isolate, and receive medical care until they are no longer infectious. Safer infection could have value for various groups of workers and students. Health professionals place themselves at risk of infection daily and extend this risk to their family members and (...) community. Similarly, other essential workers who face workplace exposure must continue their work, even if have high-risk household members and live in fear of infecting. When schools are kept closed because of the fear that they will be sites of significant transmission, children and their families are harmed in multiple ways and college students who are living on campus, whether or not they are attending classes in person, are contributing to high rates of transmission and experiencing high rates of exposure. We consider whether offering safer infection sites to these groups could be ethically defensible and identify the empirical unknowns that would need to resolve before reaching definitive conclusions. This article is not an endorsement of intentional infection with the coronavirus, but rather is meant to spark conversation on the ethics of out-of-the-box proposals. Perhaps most meaningfully, our paper explores the value of control and peace of mind for those among us most impacted by the pandemic: those essential workers risking the most to keep us safe. (shrink)

As concerns about the negative health effects of unhealthy eating and overweight/obesity increase, so too do efforts to combat obesity. Both the federal government, as well as state and local governments, have proposed and implemented a variety of healthy eating and obesity prevention policies. Many of these policies are controversial, facing objections that range from the practical to the ethical. In this paper, we consider one such policy — restrictions on food assistance programs that are meant to improve participants’ diet (...) — and one criticism of these policies, that they are inequitable. We take as our primary example the recent, unsuccessful effort by New York State to exclude sweetened beverages from the items eligible for purchase in New York City with Supplemental Nutrition Assistance Program. (shrink)

As the COVID-19 pandemic continues to evolve, taking its toll on people’s lives around the world, vaccine passports remain a contentious topic of debate in most liberal democracies. While a small literature on vaccine passports has sprung up over the past few years that considers their ethical pros and cons, in this paper we focus on the question of when vaccine passports are politically legitimate. Specifically, we put forward a ‘public reason ethics framework’ for resolving ethical disputes and use the (...) case of vaccine passports to demonstrate how it works. The framework walks users through a structured analysis of a vaccine passport proposal to determine whether the proposal can be publicly justified and is therefore legitimate. Use of this framework may also help policymakers to design more effective vaccine passports, by incorporating structured input from the public, and thereby better taking the public’s interests and values into account. In short, a public reason ethics framework is meant to encourage better, more legitimate decision-making, resulting in policies that are ethically justifiable, legitimate and effective. (shrink)

Ross and MacKay argue that excluding sugar-sweetened beverages from the Supplemental Nutrition Assistance Program is ‘in principle morally permissible’ because it does not violate the central obligation that SNAP is meant to discharge—the obligation to ensure that citizens have secure access to food adequate to meet their nutritional needs. I query this argument, and suggest two other ways of understanding the core purpose of SNAP. According to the first, the core purpose of SNAP includes promoting good nutritional outcomes; thus, one (...) might argue, including sugary drinks in SNAP undermines its core purpose. According to a second conception of SNAP, its core purpose ought to be much broader: promoting good nutritional outcomes, ensuring food security and providing secure access to other food-related goods, such as pleasure, social experiences and cultural expression. (shrink)

The body and bodily experience make little appearance in analytic moral philosophy. This is true even of analytic sexual ethics—the one area of ethical inquiry we might have expected to give a starring role to bodily experience. I take a small step toward remedying that by identifying one way in which the bodily experience of sex is ethically significant: some of the physical actions of sex have a default expressive significance, conveying trust, affection, care, sensitivity, enjoyment, and pleasure. When people (...) having sex don't in fact have these feelings, the sex can be misleading, even if they've antecedently communicated that they don't have these feelings. This account of how sex can mislead is inspired by a perhaps surprising source, Catholic sexual morality. Analytic sexual ethicists could benefit from emulating Catholic sexual morality's attentiveness to the bodily nature of sex and its ethical significance. (shrink)

In the United States, roughly 1 out of 4 births takes place at a hospital certified as Baby-Friendly. This paper offers a multi-disciplinary perspective on the Baby-Friendly Hospital Initiative (BFHI), including empirical, normative, and historical perspectives. Our analysis is novel in that we trace how medical practices of “quality improvement,” which initially appear to have little to do with breastfeeding, may have shaped the BFHI. Ultimately, we demonstrate that a rich understanding of the BFHI can be obtained by tracing how (...) norms of gender/motherhood interact with, and are supplemented by, other normative, historical, and institutional realities. We conclude with suggestions for practical revisions to the BFHI. (shrink)

Breastfeeding and human milk are the normative standards for infant feeding and nutrition. Given the documented short- and long-term medical and neurodevelopment advantages of breastfeeding, infant nutrition should be considered a public health issue and not only a lifestyle choice.In a letter sent out to 2600 hospitals across the country they [Public Citizen] demand that healthcare facilities “immediately discontinue the distribution of commercial infant formula manufacturer discharge bags,” claiming it undermines women’s success at breastfeeding. What they failed to explain is (...) why a woman’s decision regarding her own tits is anyone’s fucking business but her own.Clearly, policies to promote breast-feeding.. (shrink)

Clinical use of placebos is controversial among bioethicists. While placebos have been shown to provide benefit for patients with some conditions, offering placebos to patients without disclosing that they are placebos raises ethical concerns, including the concern that this lack of transparency about the nature of placebos amounts to deceiving patients. Some have proposed open-label placebos as an ethically preferable alternative: patients are offered placebos and told that the treatment being offered is a placebo. To contribute to the ongoing discussion (...) about the ethics and feasibility of clinical use of placebos, we conducted focus groups to explore physician attitudes about clinical use of placebos, including non-disclosed and OLPs, and physician attitudes about the underlying ethical issues. We found that while the non-transparency and deceptiveness of offering non-disclosed placebos was a concern for some physicians, their primary focus when considering both non-disclosed and OLPs was identifying and weighing potential harms and benefits to patients. Some participants also felt further research and training in prescribing OLPs would be needed before they would be willing to use them in their practice. Data are available upon request. (shrink)

This paper argues that individuals in many high-income countries typically have moral reasons to limit their beef consumption and consume plant-based protein instead, given the negative effects of beef production and consumption. Beef production is a significant source of agricultural greenhouse gas emissions and other environmental impacts, high levels of beef consumption are associated with health risks, and some cattle production systems raise animal welfare concerns. These negative effects matter, from a variety of moral perspectives, and give us collective moral (...) reasons to reduce beef production and consumption. But, as some ethicists have argued, we cannot draw a straight line from the ethics of production to the ethics of consumption: even if a production system is morally impermissible, this does not mean that any given individual has moral reasons to stop consuming the products of that system, given how miniscule one individual’s contributions are. This paper considers how to connect those dots. We consider three distinct lines of argument in support of the conclusion that individuals have moral reasons to limit their beef consumption and shift to plant-based protein, and we consider objections to each argument. This argument applies to individuals in high beef-consuming and high greenhouse gas-emitting high-income countries, though we make this argument with a specific focus on the United States. (shrink)

References to the ‘natural’ are common in public health messaging about breastfeeding. For example, the WHO writes that ‘Breast milk is the natural first food for babies’ and the U.S. Department of Health and Human Services has a breastfeeding promotion campaign called ‘It’s only natural’, which champions breastfeeding as the natural way to feed a baby. This paper critically examines the use of ‘natural’ language in breastfeeding promotion by public health and medical bodies. A pragmatic concern with selling breastfeeding as (...) ‘natural’ is that this may reinforce the already widespread perspective that natural options are presumptively healthier, safer and better, a view that works at cross-purposes to public health and medicine in other contexts. An additional concern is that given the history of breastfeeding in the USA, ‘natural’ evokes specific and controversial conceptions of gender and motherhood. (shrink)

As part of the roundtable, “Ethics and the Future of the Global Food System,” this essay discusses some of the major challenges we will face in feeding the world in 2050. A first challenge is nutritional: 690 million people are currently undernourished, while 2.1 billion adults are overweight or obese. The current global food system is insufficient in ensuring that the nutritious foods that make up healthy diets are available and accessible for the world's population. Moreover, by 2050, as the (...) global population increases, food demand will increase by 50–60 percent. A fundamental challenge is meeting this demand while not wreaking irreversible havoc on natural resources, the environment, and planetary systems. A body of scientific research has coalesced around the need to reduce food loss and waste, adopt environmentally sustainable production practices, and shift toward plant-dominant diets. Other long-standing food system problems include deficits in providing fair wages and decent working conditions for food system workers, threats to smallholder farmer livelihoods, and tens of billions of animals kept in welfare-deficit confinement conditions. These food system challenges are bad states of affairs that matter from a variety of moral perspectives. In other words, there is a robust moral case for addressing these challenges. Yet concerted policy action in this area is insufficient and largely absent, pointing to the underlying challenge and complexity of political inertia. (shrink)

We propose that marketing of unhealthy foods and beverages to Black and Latino consumers results from the intersection of a business model in which profits come primarily from marketing an unhealthy mix of products, standard targeted marketing strategies, and societal forces of structural racism, and contributes to health disparities.

Even though the phenomenon of gentrification is ever-growing in contemporary urban contexts, especially in high income countries, it has been mostly overlooked by normative political theorists and philosophers. In this paper we examine the normative dimensions of gentrification through the lens of food. By drawing on Huber and Wolkenstein’s (Huber and Wolkenstein, Politics, Philosophy & Economics 17:378–397, 2018) work, we use food as an example to illustrate the multiple ways in which life plans can be located and to argue that (...) both existing residents and newcomers have an interest in occupancy rights. More specifically, while newcomers have an interest in moving freely to new neighbourhoods in order to purse their preferred life plans, they also have an interest in being able to continue to pursue those life plans once they have acquired them, and this requires occupancy rights and the implementation of measures aimed at regulating and slowing down gentrification. Moreover, when residents belong to already disadvantaged groups, more significant anti-gentrification measures can be implemented in order to prevent injustices from being compounded. (shrink)

This paper describes the results of a multi-country survey of governance approaches for the use of digital contact tracing (DCT) in response to the COVID-19 pandemic. We argue that the countries in our survey represent two distinct models of DCT governance, both of which are flawed. The “data protection model” emphasizes privacy protections at the expense of public health benefit, while the “emergency response model” sacrifices transparency and accountability, prompting concerns about excessive governance surveillance. The ethical and effective use of (...) DCT in the future requires a new governance approach that is better suited to this novel use of mobile phone data to promote public health.”. (shrink)

This essay uses a specific example—proposals to exclude sugary drinks from the Supplemental Nutrition Assistance Program —to explore some features of the contemporary U.S. administrative state. Dating back to the Wilsonian origins of the U.S. administrative state there has been uncertainty about whether we can and should separate politics and administration. On the traditional view, the agencies are to be kept separate from politics—technocratic and value-neutral—although they are indirectly accountable to the president and Congress. The SNAP exclusions example shows, however, (...) that agencies often must make complex and controversial decisions on their own, decisions that go beyond value-neutral technocratic administration. When authorizing legislation has multiple goals, as we’ll argue is the case in the SNAP example, an agency will have to choose between conflicting statutory mandates. Moreover, as the SNAP example shows, agencies often face complex normative questions of ethics and justice that go beyond the question of how to balance competing aims. The appropriate response to the SNAP exclusions example is not to keep politics out of administrative decision-making, but to develop procedures that allow ethical and political questions to be addressed in agency policy-making, consistent with overarching commitments to fairness and democracy. (shrink)

Behavioral weight loss interventions that promote healthy eating as a way to achieve and maintain healthy weights do not work for most people. Most participants encounter significant challenges to behavior change and do not lose weight or maintain meaningful weight loss. For some, there may be negative consequences of participating in a BWLI, including social, psychological and economic costs. The literature is largely silent on these negative unintended consequences, but they are important for both practical and ethical reasons. If efforts (...) to eat healthier have too many negative consequences for individuals and groups, then these efforts are unlikely to be effective, and promoting them may not always be ethical; this would boost the case for moving away from individual-focused efforts as part of healthy eating efforts. Alternatively, if we can make BWLI interventions more effective and more ethical by mitigating these unintended consequences, then it may be too soon to give up on individual-focused efforts. We make a case for systematic assessment and reporting of the unintended consequences of BWLI. This could contribute to more effective and ethical BWLI and inform obesity interventions and policies more broadly. (shrink)

References to the ‘natural’ are common in public health messaging about breastfeeding. For example, the WHO writes that ‘Breast milk is the natural first food for babies’ and the U.S. Department of Health and Human Services has a breastfeeding promotion campaign called ‘It’s only natural’, which champions breastfeeding as the natural way to feed a baby. This paper critically examines the use of ‘natural’ language in breastfeeding promotion by public health and medical bodies. A pragmatic concern with selling breastfeeding as (...) ‘natural’ is that this may reinforce the already widespread perspective that natural options are presumptively healthier, safer and better, a view that works at cross-purposes to public health and medicine in other contexts. An additional concern is that given the history of breastfeeding in the USA, ‘natural’ evokes specific and controversial conceptions of gender and motherhood. (shrink)